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global health," Warne said. "They had no clue what was happening in Indian country when it comes to health disparities." • Warne, 47, who has worked on tribal lands as a primary care doctor, health consultant and researcher, said he decided to start a program rather than complain about it. • "It actually feels like I am working further upstream than I have at any time in my career," said Warne, who last year was nominated by two American Indian groups to become the next U.S. surgeon general. "The quality of students we are bringing in are remarkable. This is something I find very gratifying." • Students say they were drawn to the program partly because they are learning from health care experts who are Native Americans. Warne is one of three American Indian teachers in the program, along with Donna Grandbois, assistant professor of nursing, and Linda Frizzell, American Indian data coordinator. • "As a Native American tribal member, nurse and health educator, I have seen firsthand the devastating results of the grave health disparities and inequities that continue to exist among Native people, both urban and those living on reservations," Grandbois said. • Statistics from the Indian Health Service show that American Indians and Alaska Natives have a life expectancy that is more than four years fewer than the rest of U.S. citizens. A Census Bureau survey last year showed that those two groups have the highest national poverty rate at 27 percent, which Warne said creates further challenges to improving overall health of the population. • Warne came from one of the poorest tribes in the country on the Pine Ridge Indian Reservation. • "Indian Health Service is terribly underfunded," Warne said. "There's a saying in Indian health: Don't get sick after June. The reason is we run out of money. That is the fault of Congress. We have a lot of things stacked against us in terms of poverty and politics." • There are 18 core credit hours in the program, including classes on American Indian health policy, health disparities, cultural competence, research and case studies. Students are required to take one elective course and complete a practicum and masters paper. The program is open to anyone in the country through distance education. • One of the students turned her focus toward indigenous food systems and has helped to maintain five community gardens in the Fargo area that are used by about 130 families. Another student has elected to study American Indian elder care. • Jacob Davis, 33, is an enrolled member of the Turtle Mountain Band of Chippewa in North Dakota, where he spent several years working on a genetics re (Continued on page 18)
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